Sleep quality and sleep disruptive factors in adult patients in the intensive care unit: Feasibility and acceptability of the daily use of self-report for sleep quality assessment in the ICU in Saudi Arabia

Background: Poor sleep quality is common in ICU patients, where various sleep disruptive factors are associated with poor sleep in ICUs. Sleep assessment on a daily basis in ICU patients is challenging important to enable nurses to recognise poor sleep and develop appropriate interventions and support to manage this. One such tool recommended in recent literature for undertaking daily sleep assessment is the Richards Campbell Sleep Questionnaire (RCSQ). However, there is little evidence of its feasibility and acceptability in daily use in ICU clinical practice and no evidence of its use in Arab speaking countries. Furthermore, data about patients' sleep quality and sleep disruptive factors in ICUs in Arabic speaking countries, particularly Saudi Arabia is limited. Aim: The aim of the study reported on in this thesis was to develop and test the psychometric properties, and feasibility and acceptability of daily self-report assessment of sleep quality in an ICU setting in Saudi Arabia using an Arabic version of the RCSQ (the RCSQ-A). The study also aimed to report on sleep quality and sleep disruptive factors among ICU patients in Saudi Arabia. Design and methods: The study was carried out in Saudi Arabia in a mixed medical and surgical ICU using a two-phase design. The first phase involved two steps: in the first step, the RCSQ was translated into Arabic, while the second step involved testing the internal consistency and reliability of the RCSQ-A in an initial pilot sample of 57 ICU patients. Content validity was also examined in a subsample of 30 ICU patients using a cognitive interviewing method. The second phase was a prospective observational repeated measures study carried out over a three-month period. In this phase, 120 ICU patients were asked to rate their previous night's sleep quality on a daily basis using RCSQ-A alongside a self-report of sleep disruptive factors using the modified Sleep in Intensive Care Questionnaire (SICQ) until their discharge from the ICU. Data regarding the feasibility and acceptability of repeated measurement using the RCSQ-A were collected. The correlations between self-reported sleep disruptive factors, patients' demographic and clinical variables, and patients' self-reported sleep quality were assessed. Results: The Arabic version of the RCSQ (RCSQ-A) showed evidence of content validity and internal consistency with a Cronbach’s alpha of 0.89 for self-report sleep quality assessment in an Arabic ICU patients. The RCSQ-A was shown to be feasible and acceptable to the ICU patients for daily self-report sleep assessment with self-completion requires external assistance to complete RCSQA. Sleep quality in the participants was generally poor; their sleep patterns were characterised by light sleep with frequent awakenings. Factors disrupting sleep were multiple and highly varied. Nevertheless, noise, talking and fear, were the highest-rated disruptive factors. In the multiple regression analysis , factors which significantly associated with patient sleep [exp(b), p-value] were previously receipt of Midazolam [-6.424, p<0.0005] and Propofol sedation [-3.600, p<0.05], noise [-1.033, p<0.05], daytime sleepiness [0.856 p<0.05], the presence of mechanical-ventilation [-1.218, p<0.05], and sex differences [1.836, p<0.05]. Conclusion: The results from this study highlight that the RCSQ-A is a feasible and acceptable measure for daily routine use for self-report sleep assessment in Saudi ICU clinical practice. Further research would be useful to contribute to the growing body of research addressing its effectiveness in middle eastern populations. The results highlight the importance of routinely inquiring about ICU patients' sleep quality and identifying individual sleep disruptive factors to develop individualised interventions to meet patient needs. This thesis can thus be viewed as a solid foundation for further research, which is required to strengthen, expand on, and confirm the findings contained herein

Biosorption of some Heavy Metals by Metal Resistant Bacillus thuringiensis Isolated from Soil in Basra Governorate- Iraq

In present study heavy metal resistant bacteria were isolated from soil collected from Fao district in Basra governorate South of Iraq.  On the basis of morphological, biochemical, 16S rRNA gene sequencing and phylogeny analysis revealed that, the isolates were authentically identified as Bacillus thuringiensis. The minimal inhibitory concentration (MIC) of isolates against cadmium (Cd) and lead (Pb) was determined on solid medium. B. thuringiensis showed significant resistance to high concentrations of Pb (1800 mg/l) and Cd (50 mg/l). The biosorption capabilities of B. thuringiensis for Cd and Pb were monitored at different ion concentrations and contact times. The functional groups of bacterial surface were determined using Fourier transform infrared, and X-ray powder diffraction analysis. Key Words: Bacillus thuringiensis, Minimal Inhibitory Concentration, Biosorption, Fourier transform infrared, X-ray powder diffractio

Prospective repeated assessment of self-reported sleep quality and sleep disruptive factors in the intensive care unit: acceptability of daily assessment of sleep quality

Introduction: Despite the importance of sleep, the assessment of sleep quality does not form part of standard clinical care in intensive care unit (ICU). Continuous assessment of self-reported quality of ICU patients’ sleep has been strongly recommended. Prior to implementing such an assessment in the ICU, it is important to assess the acceptability of this method of assessment to the ICU’s patients. The aims of this study were to assess the acceptability to ICU patients of completing daily self-reports on sleep quality during their ICU stay and to assess ICU patients’ self-reported sleep quality and sleep disruptive factors during their time in ICU. Methods: An observational prospective-repeated assessment was conducted on n=120 patients in an ICU in Saudi Arabia. The participants were both intubated and non-intubated. Outcomes measures: Over a 3-month period, sleep quality was assessed using the Arabic version of the Richards-Campbell Sleep Questionnaire (RCSQ-A), and self-reported sleep disruptive factors were identified. Clinical factors, such as ICU interventions, and previously administered sedatives were also examined. The patients’ acceptance of completing daily RCSQ-A reports was assessed using various indicators of acceptability. Results: A total of 381 self-reports (RCSQ-A) were collected for this analysis. The patients reported 34.4±5.60, indicating that sleep quality was poor on average. The group of intubated patients reported much poorer sleep quality during intubation than after extubation. In the multivariate analysis, factors which most significantly affected sleep (exp(b), p value) were midazolam (−6.424, p&lt;0.0005), propofol (−3.600, p&lt;0.05), noise (−1.033, p&lt;0.05), gender (1.836, p&lt;0.05), daytime sleepiness (0.856, p&lt;0.05) and the presence of mechanical ventilation (−1.218, p&lt;0.05). Conclusion: The acceptability and feasibility of using daily RCSQ-A for sleep quality assessment was demonstrated. Sleep quality was reported as poor by all participants and the factors affecting sleep were varied. This study provided various recommendations for healthcare providers and researchers in terms of evaluating and improving sleep quality in ICU patients

On fractional order dengue epidemic model

This paper deals with the fractional order dengue epidemic model. The stability of disease-free and positive fixed points is studied. Adams-Bashforth-Moulton algorithm has been used to solve and simulate the system of differential equations.This project was funded by the Deanship of Scientific Research (DSR), King Abdulaziz University, under Grant no. 3-130/1433HiCiS

Investigating the relationship between knowledge management practices and organizational learning practices in the universities’ environment

The concept of knowledge management (KM) and organizational learning (OL) has been embraced by organizations to complement each other. Higher education institutions have embraced KM and OL as a means to improve organizational efficiency. This research explores the link between KM and OL. The target population included all the 432 academicians and administrators from 35 public universities in Iraq. The sampling was selected using a stratified random sampling technique. The correlation among the components of KM and OL was tested as well as the effect of KM components on OL. The findings were derived using smart partial least square. The findings showed that there is significant correlation between components of KM and components of OL. The regression analysis showed also that the effect of KM and its components; knowledge creation, knowledge sharing, knowledge storage, knowledge application and knowledge acquisition on OL are significant. These findings provide insights to universities management on strategies to implement KM practices that can align with OL practices to assure dynamic lifelong mechanisms for the basic daily activities such as teaching, learning, researching, and supervision

Synthesis and characterization of sodium alginate/polyvinyl alcohol/zinc oxide/iron oxide nanocomposites for electrochemical applications

Polymer nanocomposites films, based on sodium alginate (NaAlg) and polyvinyl alcohol (PVA) complexed with zinc oxide nanoparticles (ZnO NPs) and iron oxide nanorods (Fe3O4 NRs) as nanofiller, were prepared by solution casting technique. Different techniques were used to describe the prepared films. XRD and FTIR were used to pinpoint the complexation of the nanofiller with the polymer mixture. The XRD investigation verified the existence of the crystalline peaks of ZnO/Fe3O4 NPs in the polymeric matrices. The average particle size of nanocomposite was 23 nm. TEM image of the ZnO nanopowder confirming the spherical form of nanoparticles with average size 30 nm. The TEM image of Fe3O4 NRs reveals the free nanorods are around 9–23 nm in diameter and 130–350 nm in length. Peak positions and intensity variations in the FTIR absorption spectra are observed when the concentration increases from 2 to 8 wt% of ZnO NPs/Fe3O4 NRs. AC conductivity showed that the NaAlg/PVA-(8 wt%) ZnO/Fe3O4 NPs nanocomposites have higher electrical conductivity than NaAlg/PVA blend. For samples of 8% ZnO/Fe3O4, the (Formula presented.) of nanocomposites reached 3.66 × 10−8 S cm−1. ZnO/Fe3O4 nanoparticles considerably improved the nanocomposites' ability to conduct electricity. For the development of functional composite materials for the manufacture of electrical devices, sensors, and high-energy storage capacitors, the enhanced characteristics of synthesized NaAlg/PVA-ZnO/Fe3O4 nanocomposites can be helpful

Chemical and Microbiological Changes of Expired Platelet Concentrate

Nora Y Hakami,1 Abdulrahman M Al-Ahdal,1,2 Afnan J Al-Sulami,3 Httan M Alabbadi,3 Mamdouh M Sindi,4 Kholoud A Gholam,3 Maiman M Bayuomi,3 Talal Qadah1 1Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 2Hematology Department, King Salman Bin Abdulaziz Medical City, Medinah, Saudi Arabia; 3Blood Transfusion Services Unit, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 4Clinical Chemistry Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaCorrespondence: Nora Y Hakami, Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, 21589, Saudi Arabia, Email [email protected]: Platelets are a commonly used blood component to prevent or treat bleeding in patients with thrombocytopenia or platelet dysfunction. They are stored at room temperature (22– 24°C) for five days unless specific measures are taken to extend the shelf life to seven days or more. After five days, this study evaluated platelet units’ biochemical changes and bacterial growth.Study Design and Methods: Platelet concentrate was collected from 30 random donors: 8 females and 22 males. The collected samples were then placed on an agitator at room temperature and tested for their pH, protein content, and glucose levels using Roche Combur 100 Test® Strips. The Haemonetics eBDS™ System was used for bacterial detection. The measurements were taken on day five as the control and then repeated on days 7, 9, and 11 to observe any changes. On days 5 and 7, all parameters remained unchanged. However, glucose levels significantly changed (p=< 0.0001) on days 9 and 11. Regarding pH, a significant change was observed on day 9 (p=0.033) and day 11 (p=0.0002).Results: There were no significant changes in all parameters on days 5 and 7. However, glucose was substantially changed (p=< 0.0001) on days 9 and 11. For pH, there was a significant change in pH on day 9 (p=0.033) and day 11 (p=0.0002).Discussions: Our study found that platelet concentrate extension is possible for up to seven days. However, further studies are needed to evaluate platelet function during expiry time and to assess the stability of platelet morphology and function.Keywords: platelet, thrombocytopenia, storage extension, bacterial detectio